The “dreaded” tumor markers

umor markers are not a diagnosis of cancer, so we put them in a different article.

The markers do not serve as an early diagnosis before indeterminate clinics. They should be asked only when there is “suspicion” of cancer or when it is already diagnosed. They serve especially for, counting on the initial figure if it were high, to assess its evolution. Your request in healthy patients can scare the patient unnecessarily and have other unwanted effects (iatrogenesis).

If they are used without real data of suspicion of cancer, it is “bad praxis”, if they are used alone to rule out a diagnosis, it is also bad praxis, if the patient is told that we make them it is iatrogenic because they are scary, and especially if they are He says they are high without having diagnosed yet cancer is iatrogenic because they are not diagnosed with cancer.
If someone asks you for a marker without any clinical criteria, ask for explanations of why you have done it, but do not panic. If he says “it has come out high and it can be cancer” also ask him why he alarms you if he still does not know if that is cancer.

If you do not ask for more evidence that it is not acting scientifically . Some doctors believe they have the authority to request them without clinical data of “well-founded” suspicion of cancer, which they have to diagnose first. If they are asked for without more diagnosis, but the mortality is not improved, or does it increase? It is a subject that should be studied because it is not clear and there are already more than important data that we are diagnosing cancers that would not give problem to the patient.

Some say: then what do we do? Well, to begin being serious and rigorous, not to be carried away alone by fear, not to infuse fear unreasonably, not to do defensive medicine only, to use the tests when they are “indicated” according to medicine based on evidence.

As in the diagnostic chapter, I recommend that patients not read the tests because they do not understand them and can be scared for no reason, in this I recommend that if they already have a cancer do not always believe that an elevation is bad because a single elevation It is not reliable, and because an elevation can also occur when the tumor is being destroyed as we will see later.

Therefore, this test should only be requested by doctors with practice in cancer, but currently it is requested without criteria sometimes …

I will use the information from the American Cancer Society what I am going to do is put sentences not all the text, in any case I will omit things that can change the meaning of what I put, and in any case the reader can refer to the source and read it full.

What are tumor markers?
Tumor markers alone are rarely enough evidence to prove cancer .
Most tumor markers can be produced by normal cells , as can cancer cells.
Occasionally, non-cancerous diseases can also cause the levels of certain tumor markers to increase more than normal. And it may be that not all people with cancer have elevated levels of a particular tumor marker.

When a doctor observes the level of a tumor marker, he will consider it along with the patient’s history and general physical examination, as well as with the other laboratory tests and imaging studies . – But beware! That he is not saying that a marker can be made and if it goes wrong then ask for more tests, but precisely the opposite: the markers are requested when we are already diagnosing a cancer with other tests “as a complement”, but if we read it with the wording that they have made it can lead to error, however I know because they taught me that way

How are tumor markers used?
Tumor markers can be useful in a variety of ways.

1. Cancer screening and early detection

Testing for screening refers to the search for cancer in people who have not shown symptoms of the disease. Early detection means finding cancer in its early stages, when it is less likely to spread and is therefore easier to treat. – We do not agree that they should be used to search for cancer in people without symptoms, but it seems that they already give it as valid, however this is not proven “scientifically”, in fact they say it below

Tumor markers were initially developed to test people without symptoms for cancer screening , but very few markers have been able to give useful results in this way. An ideal tumor marker would be one that could be used as a blood test for the detection of the disease in all people. Such a tumor marker would only be present in people with the disease and would reveal to the doctor the type of cancer, how much cancer is present and which treatment would be the most appropriate. At present, there is no tumor marker that is so .

The most widely used tumor marker is that of the blood test for the prostate specific antigen or PSA (also known as prostate specific antigen or APE). – note: prostate specific non-cancer – This antigen test is used in the detection of prostate cancer, and men with prostate cancer usually have elevated PSA levels. But the test results are not always clear, since men with a high level of PSA have been seen without cancer ; likewise, a normal PSA level does not always mean that there is no cancer. The prostate specific antigen is not a perfect tumor marker . So far, not all doctors agree that the screening test for PSA is suitable for all men . – You do not need comments, and remember that it is the “most widely used” because then it says : –

For now, no other tumor marker is used as support in the detection of cancer in the general population . – that is, they admit that the PSA can be used, what studies support it? -Some of the tumor markers currently used may help in the detection of early-stage cancer, but can only be subject to review in people known to be at high risk of developing certain types of cancer. – That is to say that they are not saying that they can be done to anyone, for example a PSA for being a man over 40 or a CEA because your grandfather had colon cancer, to give two examples

Before continuing with what the American Cancer Society says about markers, go a little further into this topic “which is the most transcendent.” When they are asked for no reason or how supposed unscrupulous scientific evidence (such as PSA) their positivity leads to cancer diagnoses or false diagnoses and therefore also to iatrogenesis due to unnecessary dangerous diagnostic treatments or tests that should only be justified with a clinical criterion , not analytical . We have already talked about this in the article Prostate Cancer

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